Healthcare 360: Ethics in Health Care with David Sontag

October 11, 2023

Podcast: A Discussion on Ethics in Health Care

On this week’s episode of Healthcare 360, Dr. Rob Fields sits down with David Sontag, Senior Associate General Counsel and Director of Ethics at Beth Israel Lahey Health, to discuss ethics in health care.

The Pandemic as an Example

The COVID-19 pandemic was a time that called for frequent ethical decision making. Sontag explains it became necessary to address the scarcity of hospital resources in an ethical way. In order to do this, he led an ad hoc ethics group comprised of representatives from all the hospitals within the Beth Israel Lahey Health system. The goal was to look at the ethical questions raised by the pandemic and address them in a deliberate, thoughtful manner.

“We want to think about all of the different factors that should be leading or should be contributing to the [final] decision,” he says, “Making sure that we’re taking stock of different stakeholder perspectives and what the potential outcomes are as scientifically justified.”

He then discusses the four tenets to principlism as defined by bioethics which are non-maleficence, beneficence, justice, and autonomy, and how they play into that decision making.

An Individualistic Society

The United States, when compared to some of its European counterparts, is very much a country that values individualism over community. Dr. Fields mentions that health care is, to some extent, a protected public good, explaining that access to health care at the emergency department is the only public good protected at its level.

Sontag agrees but acknowledges the reality that, while patients may receive the care they need, they then need to figure out how to pay for it — which poses as an obstacle for many.

“As a society, we haven’t continued to support the community effort of caring for each other and so we’re having more and more patients who have nowhere to go or were put in facilities that they don’t want to be in that cost a lot of money that have the potential of bankrupting their families,” he says. “Because we haven’t, as a society, decided to take care of people as they age or as they become disabled.”

When asked about his final thoughts, he says, “I think healthcare, at large, needs to prove its trustworthiness and rebuild that trust, so that when we’re making these other decisions, like masking policies and those sorts of things, they [patients] can appreciate why we’re making those decisions.”

Every other week, we’ll chat with a leading expert in healthcare to learn about the many challenges and opportunities facing the industry. Listen to the full conversation with Sontag here, and check in regularly for new episodes of Healthcare 360.

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